Upper Limb 1 Flashcards

1
Q

What clinical sign do you see when the long thoracic nerve is injured?

A

Winged scapula

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2
Q

What is 14

A

Lateral head of triceps brachii muscle

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3
Q

The coracohumeral ligament strengthens what aspect of the joint capsule

A

superior aspect

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4
Q

What is 1

A

First Rib

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5
Q

When may compression of the axillary artery be necessary?

A

Profuse bleeding occurs due to severe injury to the upper limb

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6
Q

What is the action of teres major on the shoulder joint?

A

Extension of shoulder joint in saggital plane

Adducts

Medially/internally rotates

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7
Q

What is E

A

Medial border

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8
Q

What is the role of the serratus anterior

A

Important role in protraction of the scapula

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9
Q

At what anatomical point does the subclavian artery become the axillary artery?

A

Lateral border of the 1st rib

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10
Q

What is G

A

Caracoid process

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11
Q

What is C

A

Trochlea

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12
Q

What is A

A

Medial head of triceps

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13
Q

What is B

A

Axillary artery

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14
Q

What is A

A

Scapular notch

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15
Q

What is 13

A

Teres major muscle

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16
Q

What is C

A

Glenoid fossa

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17
Q

What is 2

A

Levator scapulae

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18
Q

What is the pectoral girdle

A

The set of bones which connects the upper limb to the exial skeleton on each side

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19
Q

What muscles abduct the shoulder?

A

Middle part of deltoid Supraspinatus Trapezius Serratus anterior

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20
Q

What is A

A

Surgical neck

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21
Q

Injury to the lower trunk of the brachial plexus causes what?

(what is the cause of this injury, what is effected, what is it called)

A

Klumpke’s palsy

Muscles effected: -Intrinsic muscles of the hand -Ulnar flexors of the wrist and fingers

Cause of injury is undue abduction of the arm -Trying to grab a branch while falling

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22
Q

What is D

A

Anatomical neck

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23
Q

What are supraspinatus proximal and distal attatchments

A

Proximal Arises from supraspinous fossa of the scapula and from fascia overlying the muscle. The muscle converges on a tendon which passes under the acromion and above the shoulder joint.

Distal - Greater tuberosity of humerus

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24
Q

What is B

A

Superior angle

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25
Q

What is B

A

Basillican vein

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26
Q

What is E

A

Coracohumeral ligaments

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27
Q

What is 4

A

Rhomboid major muscle

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28
Q

What movement do the muscles of the subscapularis generate?

A

an adductor and medial rotator of the humerus.

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29
Q

What is I

A

Rhomboid major

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30
Q

What muscles cause lateral or external rotation?

A

Teres minor

Infraspinatus

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31
Q

What is A

A

Braciocephalic trunk

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32
Q

What is C

A

Infraspinous process

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33
Q

What is the scapulohumeral rhythm?

A

Consider abduction of the arm from the anatomical position. Initially, all movement will be at the glenohumeral joint, but beyond about the first 30 degrees, for every 3 degrees of abduction, 2 degrees occurs at the shoulder joint and 1 degree at the scapulothoracic joint (2:1 ratio)

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34
Q

What muscles are effected by Erb’s palsy? What nerves supply them?

A

Biceps brachii - Brachialis, Coracobrachialis (Musculocutaneous nerve)

Brachioradialis - (Radial nerve)

Deltoid - (Axillary nerve)

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35
Q

What is F

A

Subscapular fossa

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36
Q

What is J

A

Triceps brachii

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37
Q

What is 9

A

Lattisismus dorsi

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38
Q

What movement do the muscles of the supraspinatus generate?

A

Supraspinatus initiates abduction, and as part of the rotator cuff, helps to hold the humeral head in the socket throughout its range of movement. If supraspinatus is paralyzed, abduction may be initiated by leaning to the affected side

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39
Q

What is H

A

Inferior angle

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40
Q

What makes the median cubital vein useful for venepuncture

A

Often the median cubital vein is in a fixed position in the ante-cubital fossa

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41
Q

What is E

A

Intertubercular grove

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42
Q

What is B

A

Coronoid fossa

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43
Q

What is Purple

A

Roots

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44
Q

What forms the medial, posterior and lateral cords of the brachial plexus?

A

Lateral cord -Upper trunk and middle trunk

Posterior cord -Upper, middle and lower trunks

Medial cord -lower trunk

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45
Q

What are infraspinatus proximal and distal attachments

A

Proximal - Infraspinous fossa of scapula

Distal - The tendon inserts on the middle facet of the greater tuberosity of the humerus. There is a bursa between infraspinatus and the neck of scapula

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46
Q

What is 2

A

Spinous process of thoracic vertebrae

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47
Q

What is C

A

Supraglenoid tubercle

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48
Q

What is 5

A

Medial border of the scapula

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49
Q
A
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50
Q

Where does the serratus anterior arise from and insert to?

A

Arises as interdigitations from the ribs

Inserts into the scapula

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51
Q

What type of synovial joint are the acromioclavicular (AC) and sternoclavicular (SC) joints?

A

Acromioclavicular -> plane

Sternoclavicular -> saddle

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52
Q

What is 4

A

Clavicle

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53
Q

What is 8

A

Inferior angle of the scapula

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54
Q

What is 8

A

Teres major

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55
Q

What is B

A

Coricoid process

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56
Q

What is A

A

Trapezius

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57
Q

What is H

A

Rhomboid Minor

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58
Q

What muscles cause protraction of the scapula?

A

Serratus anterior

Pectoralis major and minor

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59
Q

The coracoacromial arch is made up of what 3 structures?

A

Acromion

Coracoid process of the scapula

Coraco-acromial ligament

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60
Q

What is F

A

Olecranon fossa

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61
Q

What is D

A

Axillary vein

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62
Q

What is F

A

Dorsal Venous network

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63
Q

What is the funtcion of the serratus anterior?

A

Protraction of the scapulae, but mainly serves to stabilise it during limb movements and to keep it pulled against the thoracic cage

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64
Q

What is 12

A

Posterior surface of scapula

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65
Q

What is 12

A

Long head of triceps bcrachii muscle

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66
Q

What are subscapularis proximal and distal attatchments

A

Proximal - Medial 2/3 of costal aspect of scapula

Distal - It passes laterally, forming a broad tendon which inserts on the lesser tuberosity, shoulder joint capsule, and the front of the upper shaft of the humerus. Some of the superficial fibers blend with the transverse humeral ligament.

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67
Q

What muscles extend the shoulder?

A

Posterior deltoid Latissimus dorsi Teres major

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68
Q

What is 5

A

Supraspinatus

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69
Q

What is 7

A

Transverse fibres of trapezius muscle

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70
Q

Where is the pectoralis minor located

A

Pectoralis minor lies deep to the pectoralis major muscle

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71
Q

What is I

A

Glenoid fossa

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72
Q

What is 14

A

Spine of Scapula

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73
Q

What is 6

A

Acromion

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74
Q

What is D

A

Greater tubercle

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75
Q

What is D

A

Glenohumeral ligament

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76
Q

What is K

A

Inferior angle

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77
Q

The axillary artery is the continuation of which artery?

A

Subclavian artery

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78
Q

What is G

A

Levator scapulae

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79
Q

What spinal nerve roots form the brachial plexus?

A

C5 C6 C7 C8 T1

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80
Q

What is F

A

Deltoid tuberosity

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81
Q

What forms the anterior, posterior, medial and lateral walls of the axilla?

A

Anterior: -Pectoralis Major and minor

Posterior wall -Subscapularis, Teres Major and Latissimus dorsi

Medial wall -Thoracic wall and serratus anterior

Lateral wall -Intratubercular sulcus of the humerus

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82
Q

Which bursa communicates with the shoulder joint cavity?

A

Subscapula bursa

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83
Q

What is E

A

Medial border

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84
Q

What movement do the muscles of the infraspinatus generate?

A

It is an lateral rotator of the humerus, but its more important action is as a member of the rotator cuff.

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85
Q

What is D

A

Subscapular fossa

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86
Q

What is 2

A

Position of costototransverse joints

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87
Q

What is 16

A

Teres minor muscle

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88
Q

What is 15

A

Greater tubercle of humerus

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89
Q

What is 5

A

Inferior angle of the scapula

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90
Q

What is 6

A

Infraspinatus

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91
Q

What muscles cause rotation depressing the glenoid cavity?

A

Inferior trapezius Inferior part of serratus anterior

92
Q

What is 20

A

Medial intermuscular septum

93
Q

Where do lymphatic vessels from the upper limb drain?

A

Axillary nodes

94
Q

What is 11

A

Surgical neck of humerus

95
Q

What is 14

A

Infraglenoid tubercle

96
Q

What is 1

A

The trapezius muscle

97
Q

What is pink

A

Terminal branches

98
Q

What is 9

A

Inferior angle of the scapula

99
Q

What determines the name of the cords in the brachial plexus in the axilla

A

The cords are named for their position in relation to the axillary artery in the axilla.

100
Q

What is the deltopectoral triangle? Why is it important?

A

Triangular space below the clavicle, between deltoid and pactoralis major muscle. Subclavian vein is vound in this triangle for the insertion of central lines

101
Q

What is 10

A

Cut edge of trapezius muscle

102
Q

What is D

A

Superior angle

103
Q

What is F

A

Acromion process

104
Q

What is G

A

Radial Fossa

105
Q

What is 11

A

Teres minor muscle and fascia

106
Q

What is 3

A

Ascending fibres of trapezius muscle

107
Q

What is J

A

Lateral border

108
Q

What is 3

A

Fourth-seventh rib

109
Q

What is D

A

Ulnar artery

110
Q

What is 18

A

lateral head of triceps brachii muscle

111
Q

What is A

A

Brachial Plexus

112
Q

What is 13

A

Acromion

113
Q

What is 9

A

Head of humerus

114
Q

Which nerve roots form the upper trunk, middle trunk and lower trunk of the brachial plexus?

A

Upper -C5 and C6

Middle -C7

Lower -C8 and T1

115
Q

What is C

A

Superior border

116
Q

What is B

A

Coracoacromial ligament

117
Q

What is 15

A

Deltoid muscle

118
Q

What is C

A

Axillary artery

119
Q

What is G

A

Medial epicondyle

120
Q

What can help to orientate and ‘side’ a clavical

A

The lateral aspect of a clavicle is flatter than the medial aspect

The superiorsurface is smoother than the inferior surface

The conoid tubercle – attachment for the conoid ligament – is on the inferior aspect of the lateral portion of the clavicle

121
Q

What muscles adduct the shoulder?

A

Pectoralis major Latissimus dorsi Teres major

122
Q

What is 3

A

Supraspinatus muscle

123
Q

What is C

A

Glenohumeral ligament

124
Q

What is F

A

Serratus anterior

125
Q

What is 2

A

Levator scapulae muscle

126
Q

What is B

A

Coracoid process

127
Q

What is A

A

Supra-spinous process

128
Q

What is D

A

Cephalic vein

129
Q

What is B

A

Lateral head of the triceps

130
Q

What movements of the glenohumeral joint are generated by the rotator cuff muscles?

A

Abduction, lateral and medial rotation

131
Q

What is E

A

Infra-glenoid tubercle

132
Q

What is 13

A

Coracoid process

133
Q

What is 16

A

Medial intermuscular septum

134
Q

What is the action of latissimus dorsi on the shoulder joint?

A

Extends, adducts and medially rotates shoulder joint

135
Q

What muscles flex the shoulder?

A

Biceps bracii Pectoralis major Anterior deltoid Coracobrachialis

136
Q

What is yellow

A

Cords

137
Q

What is 7

A

Scapular notch

138
Q

A boil in the scapular region will drain to lymph nodes where?

A

Axilla

139
Q

What is A

A

Coracohumeral ligament

140
Q

What is 21

A

Tendon of biceps Brachii muscle

141
Q

Which part of the shoulder joint capsule is weakest, as it is not protected by muscles or ligaments?

A

The weakest area of the shoulder joint capsule is just anterior to the attachment of the long head of the triceps at the infraglenoid tubercle, and disloca- tions are most frequent in this inferior anterior region.

142
Q

What cords form the median nerve?

A

Lateral and medial cords give off fibres forming the median nerve

143
Q

What is 7

A

Infraspinatus muscle

144
Q

what is 17

A

Ulnar nerves

145
Q

What muscles cause elevation of the scapula?

A

Levator scapulae

Upper trapezius

Rhomboids

146
Q

What is 17

A

Long head of triceps brachii muscle

147
Q

What is Erb’s point and what is the clinical relevance of it?

A

Point of unison of C5 and C6 forming the upper trunk of the brachial plexus. Injury commonly sustained at this point during birth or from a fall onto the shoulder. Causes Erb’s palsy resulting in characteristic waiter’s tip appearance of the upper limb -> medialy rotated with wrist flexed

148
Q

What muscles cause depression of the scapula?

A

Lower trapezius

Pectoralis major and minor

149
Q

What is 9

A

Posterior fibres of deltoid muscle

150
Q

What is C

A

Brachial artery

151
Q

What is D

A

Glenoid Cavity

152
Q

Infection around the umbilicus (e.g. infected tattoo) would drain lymph where?

A

Above umbilicus -> axilla Below umbilicus -> superficial inguinal

153
Q
A
154
Q

What is 19

A

Medial head of triceps brachii muscle

155
Q

What is 1

A

Trapezius

156
Q

What two veins arise at the dorsal venous arch and where on this arch?

A

Cephalic vein at lateral end

Basilic vein at medial end

157
Q

What is 4

A

Rhomboideus major

158
Q

What is B

A

Scapular spine

159
Q

What is 1

A

Descending fibres of trapezius muscle

160
Q

What is E

A

Basillic vein

161
Q

What is E

A

Teres major

162
Q

What is 4

A

Rhomboid minor muscle

163
Q

What is A

A

Cephalic vein

164
Q

What is 10

A

infraspinatus muscle and infraspinateous fascia

165
Q

What is C

A

Median cubital vein

166
Q

What is G

A

Lateral border

167
Q

What cord does the ulnar nerve come from?

A

Medial cord once fibres are given off for the median nerve

168
Q

Infection in the little finger will drain to lymph nodes where?

A

Axilla

169
Q

What is 6

A

Rhomboid major muscle

170
Q

Where do the fibres of the pectoralis major originate?

A

Medial third of the clavicle, the sternum and costal cartilage of the first 6 ribs and rectus sheath

171
Q

The axillary artery continues beyond the axilla as which vessel?

A

Brachial artery

172
Q

The entire upper limb and pectoral girdle articulate at one small joint only, which is this?

A

Sternoclavicular

173
Q

What is 18

A

Olecranon

174
Q

What is 10

A

Glenoid cavity

175
Q

What is 12

A

Lattissimus dorsi muscle

176
Q

What is A

A

lesser tubercle

177
Q

What is the action of the pectoralis major on the shoulder joint?

A

Adduct and medially rotate the humerus at the glenohumeral joint

178
Q

What is 6

A

Latissimus dorsi muscle

179
Q

The median cubital vein is a large communicating vein which shunts blood from where to where?

A

cephalic vein -> basilic vein

180
Q

What is A

A

Acromion

181
Q

What is the role of the subacromial bursa?

A

Facilitates movement of the supraspinatus tendon under the coraco-acromial arch and of the deltoid over the joint capsule and the greater tubercle of the humerus

182
Q

What is the nerve supply to the trapezius?

A

Accessory nerve

183
Q

What is 8

A

Spine of scapula

184
Q

What does the cephalic vein puncture in order to drain into the axillary vein

A

The Clevipectoral fascia

185
Q

The medial and lateral portions of the breast drain lymph where?

A

Medial -> internal thoracic

Lateral -> axilla

186
Q

What common sporting injury damages the subacromial bursa?

A

Rotator cuff injury includes tendinitis and partial or complete tears; subacromial bursitis may result from tendinitis. Symptoms are shoulder area pain and, with severe tears, weakness.

187
Q

What is the nerve supply to serratus anterior?

A

Long thoracic nerve

188
Q

What is D

A

Subscapula fossa

189
Q

What is D

A

Teres minor

190
Q

What is the nerve supply to the deltoid?

A

Axillary nerve

191
Q

Where does the origin of the deltoid extend from and what is its distal attatchment

A

Lateral spine of the scapula, passing across the acromion to the lateral 3rd of the clavicle

Its distal attachment is to the deltoid tuberosity of the humerus

192
Q

What is 15

A

Medial head of triceps brachii muscle

193
Q

Name the 5 distinct groups of axillary lymph nodes

A

Anterior/pectoral group

Posterior/subscapular group

Apical group

Central group

Lateral/brachial

194
Q

What are teres minor proximal and distal attachments

A

Proximal - Teres minor arises from the upper two thirds of the lateral border of the scapula

Distal - Lesser tuberosity of humerus

195
Q

What nerves come from the posterior cord of the brachial plexus?

A

Axillary

radial nerve

Thoracodorsal nerve

Upper and lower subscapular nerve

196
Q

What is B

A

Axillary lymph nodes central groups

197
Q

What is B

A

Deltoid

198
Q

What are the 2 main Bursa in the shoulder?

199
Q

What is 7

A

Teres minor

200
Q

What is the function of the pectoralis minor

A

it splits the axillary artery into 3 parts. Along with the serratus anterior it serves to stabilise the scapula during limb movements by keeping it pulled against the thoracic cage.

201
Q

What is C

A

Infraspinatus

202
Q

What do all the different fibres of the trapezius do to the scapula?

A

Superior fibres -> elevate

Middle fibres -> retract (move back to the thorax)

Inferior fibres -> depress

203
Q

What msucles cause medial or internal rotation of the shoulder?

A

Subscapularis Lattisimus dorsi Pectoralis major Teres major

204
Q

What is Orange

A

Trunks

205
Q

What is E

A

Shaft

206
Q

What is the glenoid labrum?

A

Rim of cartilage surrounding the socket of the glenoid cavity. Doubles the glenoid depth and increases the surface area. Acts as a “chock block” limiting glenohumeral translation

207
Q

What is C

A

Head

208
Q

What is 3

A

Rhomboideus minor

209
Q

What movement do the muscles of the teres minor generate?

A

Teres minor is an adductor and lateral rotator of the humerus, and helps to oppose upward subluxation of the humerus due to the powerful actions of deltoid, biceps brachii, and triceps. Its main action is as a member of the rotator cuff.

210
Q

What is H

A

Capitulum

211
Q

What foreamen does the accessory nerve pass through?

A

The Jugular foreamen

212
Q

What is E

A

Radial artery

213
Q

Where could you test for loss of sensation in axillary nerve injury?

A

Shoulder badge region Lateral side of proximal part of arm - C5 dermatome Superior lateral cutaneous nerve of the arm

214
Q

What muscles cause retraction of the scapula?

A

Middle trapezius Rhomboids

215
Q

What is 8

A

Spine of scapula

216
Q

Musculocutaneous nerve comes from which brachial plexus cord?

A

Lateral cord once the branch for the median nerve is given off

217
Q

Which part of the clavicle is weakest and commonly breaks?

A

Junction of middle and lateral thirds

218
Q

What is H

A

Supraglenoid fossa

219
Q

What are the branches of the lateral cord of the brachial plexus?

A

Lateral pectoral

Lateral root of median nerve

Musculocutaneous nerve

220
Q

What is 11

A

Intrinsic muscle of back with fascia

221
Q

What is 16

A

Anatomical neck of humerus

222
Q

What are the branches of the medial cord of the brachial plexus?

A

Medial pectoral

Ulnar nerve

Medial root of median nerve

Medial cutaneous nerve of the arm

Medial cutaneous nerve of the forearm

223
Q

What is B

A

Radial groove

224
Q

What do each of the fibres of the deltoid do?

A

Anterior fibres -> medially rotate and flexes at the shoulder joint

Middle fibres -> abduct the arm at the shoulder joint

Posterior fibres -> extend and laterally rotate at the shoulder joint

225
Q

What is A

A

Acromion

226
Q

At what anatomical point does the axillary artery become the brachial artery?

A

Inferior border of the teres major

227
Q

What is 5

A

Position of acromioclavicular joint